Decision status: Recommendations Approved
Is Key decision?: No
Is subject to call in?: No
In the absence of Councillor Philip Dixon, Health and Wellbeing Portfolio Holder, Councillor Dyan Jones, Environment Portfolio Holder, presented the draft Cumbria Joint Public Health Strategy which was to supersede the existing South Lakeland District Council Public Health Strategy 2014-2019 as a Budget and Policy Framework document.
Councillor Jones reported that the draft Strategy had been presented to both the Overview and Scrutiny Committee and Cabinet by Councillor Dixon who had thanked all involved in its production. Councillor Jones commended the Strategy as a fine example of collaborative working and stressed the potential for the Strategy to impact on more than just public health, highlighting its links with the issues of climate change and poverty.
The report indicated how officers with multi-disciplinary backgrounds and expertise from South Lakeland District Council (SLDC), the other district councils, Cumbria County Council and the Lake District National Park Authority had contributed to the writing and the shaping of specific thematic areas.
The Public Health Strategy sat under the Cumbria Joint Health and Wellbeing Strategy 2019-2029. This strategy was currently in production, and would be presented to the Cumbria Health and Wellbeing board in April. This was a document which set out how the Health and Wellbeing Board would work together over the next ten years. All Clinical Commissioning Groups, local authorities and NHS England plans would need to take the Joint Health and Wellbeing Strategy into account.
The vision of the Cumbria Joint Public Health Strategy was to, “enable Cumbrian communities to be healthy and to tackle health inequalities.” This corresponded with the existing SLDC Public Health Strategy, and the proposed Health and Wellbeing Strategy.
The Cumbria Joint Public Health Strategy took a different approach to previous public health strategies as, instead of focusing on individuals, it acknowledged the conditions in which a person was born, lived, worked and how ages impacted on their access and ability to live a healthier life. These were known as the wider determinants of health, and included housing, education, employment, working conditions, the natural environment, food production and water. These were incorporated into Figure 1 of the report – the wider determinants of health and how SLDC interacts with these different layers. Estimates varied, however, it was broadly accepted that health care was accountable for approximately 10% of the contribution to health. This meant that, whilst access to good quality health care was very important, health was primarily determined by socio-economic factors.
The framework of the Strategy was based on the “Five Capitals Model,” which included the following:-
· Natural Capital (Planet): A high quality natural environment that provides opportunities for engagement with the natural world.
· Human Capital (People): People with the skills, knowledge, and experience that give them the capacity to take part in society and have meaningful and fulfilling lives.
· Social Capital (Participation): A good social infrastructure, with networks and institutions that allow people to connect to each other.
· Physical Capital (Place): A good physical infrastructure including housing, transport, and a commercial environment that promotes healthy behaviours.
· Financial Capital (Prosperity): Adequate financial resources that are fairly distributed.
This Strategy provided a strong framework which demonstrated the cross cutting nature of the work undertaken by SLDC. Adopting this strategic approach would improve the Council’s contribution to promoting, enabling and providing services which improved the health of its communities.
The Joint Cumbria Public Health Strategy correlated strongly with the developing SLDC Council Plan. The major themes were: health and environment; housing and communities; and economy and culture. These had all been incorporated within the Strategy. It also included sub themes of reducing inequality and sustainability, which were strongly embedded within the Strategy document.
The report detailed the key topics and aims within the Strategy and how SLDC contributed to them.
The current SLDC Public Health Strategy was for the time period 2014-19, and therefore expired this year. The new Joint Cumbria Public Health Strategy had been co-written by SLDC, the other Cumbrian local authorities and other partners. This Strategy provided a well-developed framework for actions on the wider determinants of health. It included many aims which correlated with SLDC’s own Council Plan. Due to its wider determinants focus, it was felt to be an appropriate strategy for a district council to adopt.
Implementation of the Strategy would require a collaborative cross-organisational approach, bringing together different sectors and specialisms. Following adoption, SLDC together with other local authorities would work with partners on developing an approach to implement the Strategy. If this was to be through the Health and Wellbeing Forums, then a review of this group would need to take place. A South Lakeland-based group setup around this Strategy framework would need to mirror the different aspects of health which were included in the Strategy.
Councillor Jones, expressing thanks to all involved, moved that the draft Cumbria Joint Public Health Strategy be adopted as part of the Council’s Budget and Policy Framework. She was seconded by Councillor Vicky Hughes.
Councillor Janette Jenkinson expressed the Opposition Group’s support for the Strategy, also thanking those involved in its production, including Colin Cox, Director of Public Health, who had led on the creation and development of the document, for his excellent presentation to the Overview and Scrutiny Committee. She felt that what was key was prevention of poor health and the need to engage with and encourage people to lead longer, healthier lives. She drew attention in particular to address the issue of social isolation. Councillor Jenkinson stressed the importance of taking action in order to achieve the aspirations of the Strategy.
Councillor Vivienne Rees, who had been a Member of the Council since 2006 and would not be standing for election in May and so was attending her last Council meeting, spoke passionately on the issue of health provision in rural areas which she felt to be neglected. She pointed out that there were fewer outreach clinics, meaning that patients were forced to travel to Kendal, and was of the opinion that this was due to the fact that the providers did not understand the transport problems faced by those living in rural areas. In addition, she highlighted the detrimental impact of poor public transport provision in rural areas on education, with over 16 year olds having to pay for their fares. Councillor Rees also referred to the unavailability of broadband in parts of the Langdales, as well as the lack of a playground in that area, although acknowledging the fact that South Lakeland District Council was building play areas. She was proud, however, to commend one of the two Locally Important Projects currently being funded by the Council in Grasmere, offering a trim trail and activities for the young and elderly alike. Councillor Rees emphasised the fact that there were areas within South Lakeland where people were at a disadvantage due to their age. In closing, she stressed the need for communities to continue to strive for services within their areas.
Councillor Peter Thornton highlighted the importance of the District Council’s part in delivering on parts of the Strategy. He drew attention to the links within the Strategy to climate change and to the things being done by the Council to address this issue. He pointed out the need to encourage people to live healthier lives and to the need to ensure that all had equality of opportunity. Councillor Thornton also stressed the importance of provision for safe cycling routes.
Councillor Roger Bingham highlighted the crucial support offered by voluntary organisations with regard to public health and, in particular, that offered by churches and faith groups. He also drew attention to the need for those groups to have an understanding of what services were offered by the District Council.
Councillor Giles Archibald, Leader and Promoting South Lakeland Portfolio Holder, commended the Strategy and was pleased that there appeared to be cross-party support, stressing the need to work collegially moving forward in its implementation. He drew attention to an error on page 39 of the agenda and pointed out that the County was not committed to carbon neutrality by 2030, the international target date for this being 2050. Councillor Archibald further stressed the need for consciousness with regard to biodiversity. He thanked those who had spoken and added that Councillor Rees’ passionate contribution to discussions would be missed.
Councillor David Williams queried the meaning of “blue space infrastructure”. He was disappointed to note the percentage of population with no qualifications, at 15.3% higher than the national average, with areas of the coastal belt as high as 17.6%.
Councillor Anne Hall endorsed Councillor Jenkinson’s comments and stressed the need for the Strategy to be implemented. She also spoke about the problems associated with social isolation and, for example, the need for those awarding public transport contracts to understand the impact on communities and to work collaboratively to ensure that this was dealt with in an appropriate manner. She informed Members that she would be inviting Councillor Philip Dixon, Health and Wellbeing Portfolio Holder, to Coniston, to discuss such issues. Councillor Hall was pleased to announce that the Ruskin Museum had gained full accreditation again.
Councillor Graham Vincent, Economy and Assets Portfolio Holder, felt that the Cumbria Public Health Strategy was similar to South Lakeland’s current Strategy, although somewhat fuller. He acknowledged that it included a lot of key aims, however, there were no key commitments. Councillor Vincent highlighted the major benefits to be gained from the voluntary sector which absorbed a large amount of statutory health services. He expressed disappointment in the news that South Lakeland MIND was to close and stressed the need to offer support to third sector organisations in order for them to maintain their services which alleviated the burden on statutory authorities. Councillor Vincent hoped that the Strategy would be driven and implemented. He further reminded Members of the importance of culture which, he felt, should be treated as a necessity, highlighting the fact that South Lakeland was blessed with a strong cultural offer.
The Development Strategy and Housing Manager provided clarification with regard to Councillor Williams’ query, explaining that “Blue Space Infrastructure” referred to water features such as lakes and rivers.
Following discussion, it was unanimously
RESOLVED – That the draft Cumbria Joint Public Health Strategy be adopted as part of the Council’s Budget and Policy Framework.
Publication date: 10/04/2019
Date of decision: 28/03/2019
Decided at meeting: 28/03/2019 - Council